1. Field of the Invention
The present invention relates to a medical device for placing a stretch resistant embolic device at a predetermined site within a vessel of the human body, and more particularly, relates to a catheter-based deployment system for delivering an embolic device. This device is particularly suited to transport an embolic device, such as a stretch resistant embolic coil, through the tortuous vasculature of the human brain to a selected site within the vessel or within an aneurysm.
2. Description of the Prior Art
For many years, flexible catheters have been used to place various devices within the vessels of the human body. Such devices include dilation balloons, radiopaque fluids, liquid medications, and various types of occlusion devices such as balloons and embolic coils. Examples of such catheter-based devices are disclosed in U.S. Pat. No. 5,108,407, entitled, “Method and Apparatus for Placement of an Embolic Coil” and U.S. Pat. No. 5,122,136, entitled, “Endovascular Electrolytically Detachable Guidewire Tip For The Electroformation Of Thrombus In Arteries, Veins, Aneurysms, Vascular Malformations And Arteriovenous Fistulas.” These patents and the other patents and patent applications referenced herein are hereby incorporated herein by reference. These patents disclose catheter-based devices for delivering embolic coils to preselected positions within vessels of the human body in order to treat aneurysms, or alternatively, to occlude blood vessels at a particular location.
Coils which are placed in vessels may take the form of helically wound coils, or alternatively, may take the form of randomly wound coils, coils wound within coils or other such coil configurations. Examples of various coil configurations are disclosed in U.S. Pat. No. 5,334,210, entitled, “Vascular Occlusion Assembly” and U.S. Pat. No. 5,382,259 entitled, “Vasoocclusion Coil with Attached Tubular Woven or Braided Fibrous Covering.” Embolic coils are generally formed of a radiopaque metallic material, such as platinum, gold, tungsten, or alloys of these metals. Often, several coils are placed at a given location to occlude the flow of blood through the vessel, or aneurysm, by promoting thrombus formation at the particular site.
In the past, embolic coils have been placed within the distal end of a catheter. When the distal end of the catheter is properly positioned, the coil may then be pushed out of the end of the catheter with a pusher member to release the coil at the desired location. This procedure for placement of an embolic coil is conducted under fluoroscopic visualization such that the movement of the coil through the vasculature of the body may be monitored and the coil placed at the desired location.
Another procedure involves the use of glue or solder for attaching the coil to a guidewire, which in turn, is placed within a flexible catheter for positioning the coil within the vessel at a preselected position. Once the coil is in the desired position, the coil is held in position by the catheter and the guidewire is pulled proximally to thereby cause the coil to become detached from the guidewire and released from the catheter. Such a coil positioning system is disclosed in U.S. Pat. No. 5,263,964 entitled, “Coaxial Traction Detachment Apparatus and Method.”
Still another coil positioning procedure is that of having a catheter with a socket at the distal end of the catheter for retaining a ball which is, in turn, bonded to the proximal end of the coil. The ball, which is generally larger in diameter than the outside diameter of the coil, is placed in the socket within the lumen at the distal end of the catheter and the catheter is then moved into a vessel in order to place the coil at a desired position. Once the position is reached, a pusher wire with a piston at the end thereof is pushed distally from the proximal end of the catheter to push the ball out of the socket in order to release the coil at the desired position. Such a system is disclosed in U.S. Pat. No. 5,350,397, entitled, “Axially Detachable Embolic Coil Assembly.”
Another procedure for placing an embolic coil within a vessel is that of using a heat releasable adhesive bond for retaining the coil at the distal end of the catheter. One such system uses laser energy transmitted through a fiber optic cable to apply heat to the adhesive bond in order to release the coil from the end of the catheter. Such a procedure is disclosed in U.S. Pat. No. 5,108,407, entitled “Method and Apparatus for Placement of an Embolic Coil.”
Yet another coil deployment system incorporates a catheter having a lumen throughout the length of the catheter and a distal tip for retaining the coil for positioning the coil at a preselected site. The distal tip of the catheter is formed of a material which exhibits the characteristic that when the lumen of the catheter is pressurized the distal tip expands radially to release the coil at the preselected site. Such a deployment system is disclosed in U.S. Pat. No. 6,113,622, entitled, “Embolic Coil Hydraulic Deployment System.”
Still another coil deployment system incorporates an interlocking mechanism on the coil. The interlocking end on the embolic coil couples with a similar interlocking mechanism on a pusher assembly. A control wire which extends through the locking mechanism secures the coil to the pusher assembly. The pusher assembly and embolic coil are initially disposed within the lumen of a catheter. When the embolic coil is pushed out of the end of the catheter for placement, the control wire is retracted and the coil disengages from the pusher assembly. Such a deployment system is disclosed in U.S. Pat. No. 5,925,059, entitled, “Detachable Embolic Coil Assembly.”
Yet another coil deployment system incorporates an embolic device detachably mounted on the distal portion of a pusher member and held in place with a connector thread or fiber. The fiber passes through a cutter member that may be activated to cut the connector fiber. Once the connector fiber is cut, the embolic device is released. Such a deployment system is disclosed in Published U.S. Patent Application No. 2002/0165569, entitled, “Intravascular Device Deployment Mechanism Incorporating Mechanical Detachment.”
Still another coil deployment system incorporates an embolic device with a stretch resistant member therethrough. The distal end of the stretch resistant member attaches to the embolic coil and the proximal end of the stretch resistant member is detachably mounted on the pusher member through various means such as adhesive, or by a connector fiber adhered to or tied to the pusher member, and is detachable by the application of heat. Such a deployment system is disclosed in Published U.S. Patent Application No. 2004/0034363, entitled, “Stretch Resistant Therapeutic Device.”
Still another coil deployment system incorporates a pusher wire with a stiff wavy-shaped end segment which is coupled to the embolic coil and is placed in the lumen of the catheter. The coil is advanced through the catheter until it reaches a predetermined site in the vessel at which time the pusher wire is retracted and the embolic coil is released. Such a system is disclosed in U.S. Pat. No. 6,203,547, entitled, “Vaso-occlusion Apparatus Having A Manipulable Mechanical Detachment Joint And A Method For Using The Apparatus.”
A still further embolic device deployment system for placement of an embolic device, or coil, includes a delivery catheter and a flexible pusher member. The embolic device is retained by an interlocking mechanism which includes a detachment member which extends through an aperture in an engagement member. The engagement member engages a ring on the embolic device. When the detachment member is withdrawn from the aperture, the embolic device is released. One such deployment system is disclosed in Published U.S. Patent Application No. 2006/0276823, entitled, “Embolic Coil Delivery System With Mechanical Release Mechanism,” and assigned to the same assignee as the present application.
Other known methods of deploying an embolic device to a body vessel include those which are pressure-based, rather than being mechanical in nature. For example, in one exemplary system, a flexible catheter has a distal section in which the proximal end of an embolic device is received in a fluid-tight relationship. Upon the application of fluid pressure to the lumen of the catheter (typically by a syringe), the distal section of the catheter will radially expand, thereby releasing the embolic device. Such a system is described in U.S. Pat. No. 6,113,622, entitled, “Embolic Coil Hydraulic Deployment System,” and assigned to the same assignee as the present application. Other known pressure-based deployment systems are described in U.S. Pat. Nos. 6,361,547; 6,544,225; 6,607,538; 6,689,141; 6,811,561; 6,958,068; and 6,554,849.
One characteristic of many known pressure-based deployment systems is that they use a flexible catheter to push the embolic device through the vasculature. This stands in contrast to typical embolic device deployment systems wherein an embolic device is pushed through the vasculature by a metallic hypotube guided by a flexible catheter. The use of a hypotube can be desirable due to the superior column strength and pushability of a hypotube, which allows the deployment system to be moved through stenosed regions of a body vessel without buckling or folding back upon itself.
Another characteristic of many known pressure-based deployment systems is that the embolic coil is tightly retained by the catheter or a flexible retention sleeve. The fact that the distal end of the catheter or retention sleeve must radially expand to release the embolic device may limit the outer diameter of the device and/or the diameter to which it can expand, to ensure that the expansion of the catheter or retention sleeve does not harm the surrounding body vessel.
Yet another characteristic of many known pressure-based deployment systems is that they depend on a carefully calibrated fluid seal between the catheter and the embolic device. The catheter must securely hold the embolic device so that it is not prematurely released during delivery, but it must be adapted to release the embolic device at a preselected pressure. Dimensional variations inherent in the manufacturing process create the risk that the fit between the catheter and the embolic device will be too tight or too loose or comprise an incomplete fluid seal. If the catheter holds the embolic device too tightly, it may require more fluid pressure to release the embolic device, which pressure may not be attainable by the syringe or which pressure may endanger the body vessel. If the catheter holds the embolic device too loosely, it may release the embolic device before being delivered to the target site. If an incomplete fluid seal is formed between the catheter or sleeve and the associated embolic device, it may be very difficult or even impossible to develop the necessary pressure to release the embolic device. Even if possible, developing the necessary pressure may take longer than expected, thereby increasing the time required to deploy the embolic device.
With the present approach, it has been determined that characteristics such as these may be less than desirable. The present approach recognizes and addresses shortcomings of these characteristics to provide enhancements not heretofore available.